Loading...
HomeMy WebLinkAboutPBA LTD South; 2022-08-03; PWM23-1908TRANPWM23-1908TRAN Levante Grate and Frame Repair Page 1 of 7 City Attorney Approved 1/22/2020 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT LEVANTE GRATE AND FRAME REPAIR This agreement is made on the ______________ day of _________________________, 2022, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and PBA, LTD South, a California corporation whose principal place of business is 4135 Park Dr., Carlsbad, CA 92008 (hereinafter called "Contractor"). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, addendum(s) to said Plans and Specifications, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, all of which are incorporated herein by this reference. When in conflict, this Contract will supersede terms and conditions in the Contractor’s proposal. LABOR. Contractor will employ only skilled workers and abide by all State laws and City of Carlsbad Ordinances governing labor. GUARANTEE. Contractor guarantees all labor and materials furnished and agrees to complete the Project in accordance with directions and subject to inspection approval and acceptance by: Eric Martinez (City Project Manager) PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. WAGE RATES. The general prevailing rate of wages for each craft or type of worker needed to execute the Contract shall be those as determined by the Director of Industrial Relations pursuant to Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the applicable wage rates is on file in the Office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in execution of the Contract. Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107.5. The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code or engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which generally requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Section 1776. DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED 3rd August PWM23-1908TRAN Levante Grate and Frame Repair Page 2 of 7 City Attorney Approved 1/22/2020 Kevin Doherty FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five (5) years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: ___________________________________ Print Name: ___________________________________ REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers’ Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than……..$1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ….…$1,000,000 Property damage insurance in an amount of not less than……..$1,000,000 Automobile Liability Insurance in the amount of $1,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or non- scheduled. The automobile insurance certificate must state the coverage is for “any auto” and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that 30 days written notice shall be given to the City prior to such cancellation. The policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS’ COMPENSATION AND EMPLOYER’S LIABILITY. Workers’ Compensation limits as required by the California Labor Code. Workers’ Compensation will not be required if Contractor has no employees and provides, to City’s satisfaction, a declaration stating this. DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED PWM23-1908TRAN Levante Grate and Frame Repair Page 3 of 7 City Attorney Approved 1/22/2020 BUSINESS LICENSE. The Contractor and all subcontractors are required to have and maintain a valid City of Carlsbad Business License for the duration of the contract. INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, from all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys’ fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within ten (10) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within thirty (30) working days after receipt of Notice to Proceed. CONTRACTOR’S INFORMATION. PBA, LTD South 4135 Park Dr. (name of Contractor) 1081694 (street address) Carlsbad, CA 92008 (Contractor’s license number) A & B 9/30/2023 (city/state/zip) 760-801-5238 (license class. and exp. date) 1000834464 6/30/2023 (telephone no.) kevin.pbalimited@gmail.com (DIR registration number and exp. date) (e-mail address) /// /// /// /// /// /// /// /// /// /// DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED PWM23-1908TRAN Levante Grate and Frame Repair Page 4 of 7 City Attorney Approved 1/22/2020 AUTHORITY. The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR PBA, LTD SOUTH a California corporation CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Kevin Doherty, President & Secretary Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager (print name/title) By: (sign here) (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Group B Chairman, President, or Vice-President Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney BY: _____________________________ Assistant City Attorney DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED PWM23-1908TRAN Levante Grate and Frame Repair Page 5 of 7 City Attorney Approved 1/22/2020 EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each subcontractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each subcontractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a subcontractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Type of Work to be Subcontracted Business Name and Address DIR Registration No. License No., Classification & Expiration Date % of Total Contract NONE Total % Subcontracted: 0% The Contractor must perform no less than 50% of the work with its own forces. DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED PWM23-1908TRAN Levante Grate and Frame Repair Page 6 of 7 City Attorney Approved 1/22/2020 EXHIBIT B Levante Grate and Frame Repair The Contractor shall provide all materials, labor, equipment and any required traffic control needed to build and install a new storm drain grate and repair the rear portion of the grate frame located at northeast corner of Levante St. and Anillo Way, as pictured below. The grate and all repair work shall be fabricated per the San Diego Regional Standard Drawing (D-15), the Standard Specifications for Public Works Construction- Greenbook, and the San Diego Regional Standard Drawings and City of Carlsbad Standards and Drawings. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 Provide new grate and repair drain frame at the northeast corner of Levante-Anillo streets $4,950 TOTAL* $4,950 *Includes taxes, fees, expenses and all other costs. DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED PWM23-1908TRAN Levante Grate and Frame Repair Page 7 of 7 City Attorney Approved 1/22/2020 EXHIBIT B Levante Grate and Frame Repair (cont.) DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED I ~5l8" I •• 3/8" • ROUNO 8ARS I _I _ --7 -,-I A A le. ~ ~ 2 1/'/", JIB" l "' DiO 8ARS ' ._ B .., lo '-~ I L I I I 3-1/2" X 3/8" fJNl:S:.; BJ j1/ 3/16" AUD Wil.D FUU. OEPIH l'.ACH SttE ON 3'-•· O\mllE 8ARS 4 EV£RY THIRO INTERKAl BEARING PLAN TERUINAI. SAR 3/8" f • 1/8" ROOHO BARS\/ , ,(1YP) 7/16" 11 2-112·, 3/8"~ v, - 2-1/2" X 3/8"_;00- N :::- I n El<O IWS El<O 8AR5 SECTION A-A SECTION B-8 NOTES 1. HOT-OJI> CAI.VAJ«Z[ All PARlS AFTER FABRICATION, 2. OIUENSIONS ARE TO CEtm:RLt<E or BARS UNUSS OTHER'MiiE NOTEO. 3. NOT TO BE US(O IN PEDESTRIAN «JS. 4. WEICHT: 200 POUNDS + /-. Re'tision By i\OOroved Dote SAN DIEGO REGIONAL STANDARD DRAWING REOCMWENDED 8'Y THE SAN OIEOO R£OIONM. S'l'ANOMOS COMWITtE[ '----··· K ·• I ''"' 7c. "''"' i, Stonton 02/09 ' > tP/25/NII Edited S.S. l. ,teg.lb 0.l/11 DRAINAGE STRUCTURE GRATE "' _.. R,c.£, 192:'6 Dote E4111•d .R. i, Re;tlb 10/15 DRAI\IHG D-15 Edited r..W It VMeltli 10/18 tfJMBER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBRWVDADDLINSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCEDAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY 12/02/2021 E360 INSURANCE SERVICES 16542 Ventura Blvd #300 Encino CA 91436 Sonia Castellon (888) 862-6750 (888) 256-0809 Sonia@e360insurance.com PBA, LTD South 4135 Park Drive Carlsbad CA 92008 KINSALE INSURANCE COMPANY 38920 State national Insurance Company Inc.12831 STATE COMPENSATION INSURANCE FUND 35076 A Y Y 0100163944-0 09/23/2021 09/23/2022 1,000,000 100,000 1,000,000 2,000,000 2,000,000 B Y NXTKWDRVCW-00-CA 11/16/2021 11/16/2022 1,000,000 A 0100164143-0 09/23/2021 09/23/2022 2,000,000 2,000,000 C Y Y 9305626-2021 09/23/2021 09/23/2022 1,000,000 1,000,000 1,000,000 The City of Carlsbad is Included as Additional Insured as Respects Liability arising out of work or operations performed by or on behalf of the Contractor. 110 Days Notice of Cancellation for Non-Payment of Premium, 30 Days for all other Cancellations. City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 947 Murrieta, CA 92564 DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED ACORD® I ~ I X ~ □ [X] ~ ~ ~ □ □ ~ ~ X ~ ~ ~ x ~ I I X I I I □ ---:::::::---- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US-BLANKET Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100163944-0 09/23/2021 12:01AM at the Named Insured address shown on the Declarations PBA South LTD Additional Premium:Return Premium: $0 $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE SECTION IV – CONDITIONS, 8. Transfer of Rights of Recovery against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against persons or organizations because of payments we make for injury or damage arising out of “your work” done under a written contract with that person or organization wherein you have agreed to provide this waiver. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CAS4002 0110 Page 1 of 1 DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED I STATE ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BROKER COPY COM�ENSATJON INSURANCE FUND 9306038-21 NEW HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DA TES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME SC PAGE EFFECTIVE NOVEMBER 29, 2021 AT 12.01 A.M. AND EXPIRING SEPTEMBER 23, 2022 AT 12.01 A.M. PBA, LTD. SOUTH 4135 PARK DR CARLSBAD, CA 92008 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, THE CITY OF CARLSBAD WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, PBA, LTD. SOUTH IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03%. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: 2570 ��� NOVEMBER 29, 2021 PRESIDENT AND CEO SCIF FORM 10217 mev.7-2014) 1 OF 1 OLD DP 217 DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED COMMERCIAL AUTO NXT-0004 BM CA 0418 Includes material copyrighted by Insurance Services Office, Inc. used with its permission Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED COVERAGE – CERTIFICATE OF INSURANCE HOLDERS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM The following is added to Section II – Covered Autos Liability Coverage, A. Coverage, paragraph 1. Who Is An Insured: Any person or organization arising out of your operation, maintenance, or use, of a covered “auto”, provided that you and such person or organization have agreed under an expressed provision in a written “insured contract” or agreement or a written permit issued to you by a governmental or public authority, to add that person or organization to this policy as an additional “insured”. However, such person or organization is an additional “insured”: (1) Only arising out of the operation, maintenance, or use, of a covered “auto“ by or on behalf of the Named Insured; (2) Caused in whole or in part by your acts or omissions or the acts or omissions of those acting on your behalf; and (3) Only for bodily injury or property damage caused by an “accident” which takes place after: (a) The written “insured contract” or agreement has been executed by you; or (b) The permit has been issued to you by a governmental or public authority. This insurance does not apply to damages arising out of the negligence of such person or organization. The provisions of this endorsement also apply to such person or organization when named as a Certificate Holder on a Certificate of Insurance that affirms valid insurance coverage provided by us for the Named Insured. All other terms and conditions of the policy remain unchanged. DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100163944-0 09/23/2021 12:01AM at the Named Insured address shown on the Declarations PBA South LTD Additional Premium:Return Premium: $0 $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE A. SECTION II - WHO IS AN INSURED is amended to include any person or organization you are required to include as an Additional Insured on this Policy by written contract in effect during the policy period and executed prior to the “occurrence” of the “bodily injury” or “property damage”, but only for the vicarious liability imposed on the Additional Insured provided that such liability is caused by the sole negligent conduct of the Named Insured and is proximately caused by “your work” or “your product” for the Additional Insured. However: 1.The insurance afforded to such Additional Insured only applies to the extent permitted by law; and 2.Will not be broader than that which you are required by the written contract to provide for such Additional Insured. B. The insurance provided to the Additional Insured under this endorsement is limited as follows: 1.This insurance does not apply to “bodily injury” or “property damage” arising out of “your work” or “your product” included in the “products-completed operations hazard” unless you are required to provide such coverage by written contract. If such insurance is required by written contract, the insurance provided to the Additional Insured is limited to the alleged or actual vicarious liability imposed on the Additional Insured as a result of the alleged or actual negligent conduct of the Named Insured as a result of liability solely caused by “your work” or “your product” for the Additional Insured. 2.Any insurance provided by this endorsement to an Additional Insured shall be excess with respect to any other valid and collectible insurance available to the Additional Insured unless the written contract specifically requires that this insurance apply on a primary and non-contributory basis, in which case this insurance shall be primary and non-contributory. 3.Where there is no duty to defend the Named Insured, there is no duty to defend the Additional Insured. Where there is no duty to indemnify the Named Insured, there is no duty to indemnify the Additional Insured 4.This insurance does not apply to “bodily injury” or “property damage,” arising out of the sole negligence of the Additional Insured or any employees of the Additional Insured. CAS5010 0420 Page 1 of 2 DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED I C.With respect to the insurance afforded to the Additional Insured, the following is added to SECTION III – LIMITS OF INSURANCE: The most we will pay on behalf of the Additional Insured is the amount of insurance: 1.Required by the written contract; or 2.Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. D.Duties of the Additional Insured in the event of “occurrence”, claim, or “suit”: 1.The Additional Insured must promptly give notice of an “occurrence”, a claim which is made, or a ”suit” to any other insurer which has insurance for a loss to which this insurance may apply. 2.The Additional Insured must promptly tender the defense of any claim made or ”suit” to any other insurer which also issued insurance to the Additional Insured as a Named Insured or to which the Additional Insured may qualify as an Additional Insured for a loss to which this insurance may apply. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CAS5010 0420 Page 2 of 2 DocuSign Envelope ID: 542C3EC1-7763-41FD-A73B-FE8F27D37FED